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Cited by 60Drug-Induced Hepatotoxicity and ProtectionThyroid Disorders and TreatmentsDrug-Induced Adverse Reactions

Analysis of 90 Cases of Antithyroid Drug-Induced Severe Hepatotoxicity Over 13 Years in China

Yang, Jun, Li, Lin-fa, Xu, Qin, Zhang, Jun, Weng, Wan-wen, Zhu, Yang-jun, Dong, Meng-jie·2015·Thyroid
DOI 10.1089/thy.2014.0350
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Abstract

BACKGROUND: Antithyroid drug (ATD)-induced severe hepatotoxicity is a rare but serious complication of ATD therapy. The characteristics of severe hepatotoxicity have been reported in only a small number of patients. METHOD: Ninety patients with ATD-induced severe hepatotoxicity presenting during a 13 year period (2000-2013) who were about to undergo nuclear medicine therapy with (131)I from a sample of 8864 patients with hyperthyroidism were studied, and the outcomes were evaluated. RESULTS: The mean age of the patients with ATD-induced severe hepatotoxicity was 41.6±12.5 years (mean±standard deviation), and the female to male ratio was 2.2:1. The methimazole (MMI) dose given at the onset was 19.1±7.4 mg/day. The propylthiouracil (PTU) dose given at the onset was 212.8±105.0 mg/day. ATD-induced severe hepatotoxicity occurred in 63.3%, 75.6%, and 81.1% of patients within 4, 8, and 12 weeks of the onset of ATD therapy, respectively. The types of severe hepatotoxicity did not differ significantly between the MMI and PTU groups (p=0.188). The frequency of the cholestatic type in the MMI group (35.3%, 18/51) was higher than that in the PTU group (17.9%, 7/39), but these frequencies were not significantly different (p=0.069). The patients who were treated with (131)I received an average dose of 279.1±86.1 MBq (n=84). Therapy was successful in 60 of the 67 patients (89.6%). The success rate was equivalent (p=0.696) between the groups receiving MMI (91.7%, 33/36) and PTU (87.1%, 27/31). CONCLUSIONS: Severe hepatotoxicity tends to occur within the first three months after the onset of ATD therapy. The type of ATD-induced severe hepatotoxicity did not differ between the MMI and PTU groups. (131)I therapy is an effective treatment approach for patients with ATD-induced severe hepatotoxicity.

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Authors
Yang, J., Li, L.-F., Xu, Q., Zhang, J., Weng, W.-W., Zhu, Y.-J., & Dong, M.-J.
Affiliations
  • First Affiliated Hospital Zhejiang University (CN)
  • Department of Nuclear Medicine, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, P.R. China
ORCID
Venue
Thyroid
Publisher
SAGE Publications
Published
2015-03
Volume
25
Issue
3
Pages
278-283
ISSN
  • 1050-7256 (ISSN-L)
  • 1557-9077
DOI
10.1089/thy.2014.0350
OpenAlex
W1482362129
Cited by
60
References
23
Citations by year
2025: 1 · 2024: 4 · 2023: 4 · 2022: 5 · 2021: 4 · 2020: 11 · 2019: 9 · 2018: 5 · 2017: 6 · 2016: 8 · 2015: 2 · 2014: 1
FWCI
6.49
Type
journal article
Language
en
Open access
closed
Licence
www.liebertpub.com/nv/resources-tools/text-and-data-mining-policy/121/ (tdm)
Locations
  • Thyroid (publishedVersion)
  • PubMed (publishedVersion)
Funders
Science and Technology Program of Zhejiang Province
Topics
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Drug-Induced Hepatotoxicity and Protection
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Pharmacology › Drug-Induced Adverse Reactions
Keywords
methimazole, propylthiouracil, hyperthyroidism, cholestatic hepatitis, iodine-131 therapy, drug-induced liver injury, treatment outcomes, case series, retrospective analysis
MeSH terms
Adult, Aged, China, Female, Graves Disease, Humans, Hyperthyroidism, Liver, Male, Methimazole, Middle Aged, Propylthiouracil, Retrospective Studies, Antithyroid Agents, Thyroxine, Triiodothyronine, Treatment Outcome, Young Adult, Chemical and Drug Induced Liver Injury

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